Of course you’re correct about the great increase in energy costs during the post-1973 period being a significant factor. I’d completely spaced that part.
Government debt, surely (separate from government spending fuelled by that debt). Because availability of credit drives demand to a large degree.
It might not have been obvious but I was being sarcastic about my comments on MMT. I think it is dubious at best and dangerous bullshit at worst.
I just finished watching the 3rd season of the Crown. The political background of the Crown, in between the royal affairs (literally and figuratively) is the ongoing economic and political crisis of the UK in the late 60s and 70s… Which involved a series of devaluation of the pound, emergency loans from the IMF, crippling strikes, and on going power outages. (I didn’t know about the power outages.)
30 years prior to that British pound was the world reserve currency and it would have unthinkable, that British fiscal and monetary would be restricted by an outside organization (the IMF).
The underlying assumption of MMT is the US dollar remains the reserve currency, and isn’t tied to anything. I think it is dangerous hubris to make the assumption, since historical the vast majority of countries have defaulted or severely devalued their currency, or allowed hyper inflation to do the trick behind the scenes…
With the US debt exceeding GDP, in recent years, a return to normal interest rates of say 5-6% for the 10-years will be catastrophic. I’ll be the first to admit that I don’t understand the financial voodoo magic tricks that central banks have employed to keep inflation low, while flooding the world with liquidity. But I know there are plenty of folks a lot smarter than myself, that fear this experiment won’t end well.
So both debt and deficits matter IMO.
Alstein
3987
I suspect he didn’t want to destroy the legitimacy of the court. I think Roberts knows that would be the point of no return, and that if he does that, the Dems would court-stack when they got the Senate.
One court-stacking happens the court is weakened for good as the precedent is set
Menzo
3988
Good news/bad news sort of thing.
Good news is that the ACA will survive through 2020. Bad news is that it might die under a Dem administration now.
Ex-SWoo
3989
Seems like an easy enough of a item to reverse if the Dems take the Whitehouse though, no? Probably extendable via executive order based on precedent set.
Health care in America is…insane.
Tl;dr: Health insurer for state employees in Utah deals with high prescription drug prices by paying the employees to go to Tijuana to pick up their prescription drugs. Insurer pays for the airfare, the travel expenses, the prescription cost and the cost of an escort to take you across the border and back. Also spends money on tracking the drug supply to the pharmacies in Tijuana to ensure you aren’t getting a counterfeit.
Or, you know, we could actually fix healthcare in this country and not have to come up with ridiculous programs that pay to fly people to border cities so they can buy medicine in Mexico and Canada. WTF America?!
But, you know, how will we pay for it?
Sigh.
I know right? The warped logic is rage-inducing. “Hey guys, we found this one neat trick to save us $1 million off of the $10 million we pay for healthcare. I mean, sure, we could reform the system and spend only $5 million total, saving us $5 million in the end, but that would be SOCIALISM!!!”
November can’t come fast enough.
As a Canadian, I am seriously concerned with the supply of medicine for Canada (and Mexico). with this sort of nonsense. Why can’t the USA make healthcare great again for their citizens? Government funded healthcare has its issues but I won’t go bankrupt due to a visit to the emergency room at my local hospital.
wahoo
3995
Reducing health care costs means cutting doctor salaries/hospital payments. This is very hard to do especially since some hospitals will close. Hospitals are often the largest employers in areas or even in states in some cases. That’s a lot of people arguing against them losing money. Also have a problem that many unions HATE medicare for all and campaign against it with a passion. They hate any policy proposals that could reduce health care benefits to their members.
The drug issue is different b/c it involves trade-offs in drug innovation vs. payments. The free rider problem for US drug development is real and there aren’t many real solutions with possibly the best being a drug prize.
A lot of people who aren’t millionaires hate M4A b/c they will lose.
KevinC
3996
Yes, it’s impossible to get costs down from where they are today. We already have the cheapest healthcare in the developed world, the healthcare industry and pharmaceuticals are barely making it by.
No it doesn’t. It means preventing more illnesses that require long term care, reducing superfluous testing, and paying less for tests, medical devices, and insurance overhead / profits.
KevinC
3998
Stop it, you’re sounding like a radical. The $45/pill I paid for over the counter Allegra while I was in the hospital is perfectly reasonable, there’s really no room to reduce costs there. Or the $20 per bag of saline.
We just have to realize that as part of American Exceptionalism, we simply have no way of reducing healthcare costs. It’s Exceptionally Expensive and that’s just the way it is. America! Flags waving! Jets flying overhead!
You’re essentially redirecting money. Spend way less on administrative. Spend more on actual healing people. Which is great. Perfect.
But the thing is that all those health care dollars that aren’t going toward healing people aren’t just disappearing into CEO pockets. The health care system is massively inefficient, but it’s massively inefficient in a way that employs huge numbers of people. And, obviously, if you make it more efficient, you’re now talking about lots of those people losing their jobs.
You can work this out. But the thing is, you also need to win elections. And pretty much one guaranteed way of getting lots and lots of people not to vote for you is them fearing that you’ll kill their job. And lots of these are people who are generally supportive of you, but they also have mortgages to pay.
You need to have some pretty damn good solutions for those people beforehand. And you need to sell them effectively. Just hand-waving job retraining isn’t going to do it.
Which is why I’ve argued that while moving to Medicare For All or single-player would be ideal, getting there is a goddamn nightmare. Short of a total collapse in the current system, you’re going to need some kind of long transition. And the problem is you need to keep winning elections, because you can win one election or two elections, but then the idiot voters go for the Orange con man who undoes everything. And destruction is always, always, always easier than construction.
Well said.
By the way, since Doctors in the US get paid better then most comparable nations, should we be tackling doctors salaries as well?
That has to be a big factor.
wahoo
4001
“Stop it, you’re sounding like a radical. The $45/pill I paid for over the counter Allegra while I was in the hospital is perfectly reasonable, there’s really no room to reduce costs there. Or the $20 per bag of saline.”
There is absolutely room to cut hospital costs. But you know who doesn’t like having hospitals getting less money? Hospitals. And Hospital employees who are incredibly important.
Washington State started public option proposal based on Medicare for All. Providers reimbursed at Medicare rates. But after providers had their say, reimbursement is up to Medicare 160% in Washington. Which has zippo GOP influence. Providers/hospitals are incredibly powerful. More powerful than insurance companies.
You can argue about US health care cots but just realize Medicare for All is about wacking the hell out of most doctor salary and hospital payments.
NV Culinary union on M4A/Sanders: https://apnews.com/5f24c13759c42e38e539f24729991f4c
Oghier
4002
Yep. There is no way around this – reducing healthcare costs requires one to attack the big cost buckets in the current system. That’s not insurance and pharma. It’s doctors and hospitals.
I assume when candidates talk about pharma pharma pharma and evil insurance companies, they’re aware that these are relatively small potatoes, even if they make for good slogans. Surely someone has exposed them to the actual cost structure in the healthcare ecosystem.
If we’re going to lower salaries, then we need to re-examine costs, too (med school, liability insurance, etc). This will get very complicated and wide-reaching. It needs to be done, though. There is no other long-term option that works.
Well, this is why candidates talk about insurance company profits when what they really mean is insurance companies as a whole are wasteful. But it isn’t good politics to say, “let’s put all the insurance adjusters out of a job”
